重症急性胰腺炎穿刺引流术后早期肠内生态免疫营养的应用研究  

Application of early enteral ecological immune nutrition after puncture and drainage of severe acute pancreatitis

作　　者：周娅利 贺安勇 黄文达 Zhou Yali;He Anyong;Huang Wenda(Department of Critical Care Medicine,Shenzhen Longhua District People's Hospital,Shenzhen,Guangdong 518109,China)

机构地区：[1]广东省深圳市龙华区人民医院,广东深圳518109

出　　处：《首都食品与医药》2023年第10期47-50,共4页Capital Food Medicine

基　　金：深圳市龙华区医疗卫生机构科研项目(项目编号:2020073)。

摘　　要：目的此文主要讨论患有急性胰腺炎(SAP)后,借助于介入引流的手段来改善患者身体情况,观察采取早期肠内生态免疫营养前后的情况变化.方法将2019年12月-2022年3月期间在深圳市龙华区人民医院就诊的急性胰腺炎患者纳入到试验中.经过前期的筛选后,最终选取了30名符合诊断标准的患者,将其分为两组,其中一组是早期全静脉营养后期加肠内营养组(简称为PN小组),共计15名患者;而另一组则是肠内生态免疫小组(简称为EEIN小组),共计15名患者.前者主要是以全胃肠外营养的方式进行恢复,一周后过渡为普通肠内营养;而后者则通过超声介入的方法进行引流后24小时即借助于鼻肠营养管来为患者提供充足的养分.上述两组患者需要在治疗前7天以及采取相应措施后14天检测大量的体内指标,包括前白蛋白、C反应蛋白、T淋巴细胞以及各类不同的免疫球蛋白等.这些检测指标是评判患者接受治疗后身体改善情况的重要依据.除此之外,试验者还需及时地观察各组患者在治疗过程中的腹部情况,记录个体的感染率以及中途接受手术的概率.结果首先,经过治疗之后两组患者在转铁蛋白等多项指标上数值有所升高,其中EEIN组成员的数值要明显高于PN组成员,统计检验结果,组间存在显著差异(P<0.05).其次,两组患者在各类免疫球蛋白以及T淋巴细胞活性指标方面都有明显的提升,并且EEIN小组试验人员比PN组高,两者存在显著差异(P<0.05),然而在IgG以及IgM这两项指标上却不存在显著差异(P>0.05).此外,在经过治疗之后,两组试验人员在CRP、TNF-α等指标方面数值有所下降,并且EEIN组内成员的检测数值明显要比PN组成员低,两者存在显著差异(P<0.05).从患者腹部的变化情况来看,EEIN组患者在接受治疗之后腹部的感染率以及中途所需进行手术的可能性大大降低,并且与PN组存在明显的差异(P<0.05).结论在重Objective This article mainly discusses how to improve the physical condition of patients with acute pancreatitis(SAP)by means of interventional drainage,and observe the changes before and after early enteral ecological immune nutrition.Methods Patients with acute pancreatitis who visited our hospital from December 2019 to March 2022 were included in the trial.After preliminary screening,30 patients who met the diagnostic criteria were finally selected and divided into two groups.One group was the early total intravenous nutrition and later enteral nutrition group(called PN group),with a total of 15 patients;the other group is the intestinal ecological immune group(called EEIN group),with a total of 15 patients.The former was mainly restored by total parenteral nutrition,and then transited to general enteral nutrition one week later;the latter provides adequate nutrition for patients with nasointestinal nutrition tube 24 hours after drainage by ultrasonic intervention.The above two groups of patients need to detect a large number of body indicators,including prealbumin,C-reactive protein,T lymphocytes and various immunoglobulins,7 days before treatment and 14 days after taking corresponding measures.These test indicators are important basis for judging patients'physical improvement after treatment.In addition,the experimenter also needs to timely observe the abdominal condition of each group of patients during the treatment process,record the individual infection rate and the probability of midway operation.Results First of all,after treatment,the values of transferrin and other indicators in the two groups increased,and the values of EEIN group members were significantly higher than those of PN group members,with statistical test results P<0.05.Secondly,the two groups of patients had significant improvement in various immunoglobulins and T lymphocyte activity indicators,and the EEIN group was higher than the PN group,there was a significant difference between the two groups(P<0.05),but there was no significant d

关 键 词：急性胰腺炎 穿刺引流 腹部感染 改善营养 

分 类 号：R657.5[医药卫生—外科学]